Vascular Myelopathies

Nicholas L. Zalewski, MD Spinal Cord Disorders p. 30-61 February 2021, Vol.27, No.1 doi: 10.1212/CON.0000000000000905
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PURPOSE OF REVIEW Neurologists should be able to identify clinical and neuroimaging features that distinguish vascular disorders from other causes of myelopathy.

RECENT FINDINGS Although certain clinical features suggest a vascular etiology in acute and chronic myelopathy settings, accurate MRI interpretation within the clinical context is key. Recent studies have shown vascular myelopathies are frequently misdiagnosed as transverse myelitis, and recognition of this diagnostic pitfall is important. Many different vascular mechanisms can cause myelopathy; this article provides a comprehensive review that simplifies disease categories into arterial ischemia, venous congestion/ischemia, hematomyelia, and extraparenchymal hemorrhage.

SUMMARY It is important to recognize and manage vascular disorders of the spinal cord as significant causes of acute, subacute, and progressive myelopathy.

Address correspondence to Dr Nicholas L. Zalewski, Department of Neurology, Mayo Clinic, Mayo Clinic Building, 13400 E Shea Blvd, Scottsdale, AZ 85259, [email protected].

RELATIONSHIP DISCLOSURE: Dr Zalewski reports no disclosure.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Dr Zalewski discusses the unlabeled/investigational use of IV alteplase for the treatment of spinal cord infarction.

© 2021 American Academy of Neurology.